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Individual

JULIUS CHUCKS AJIDE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
1770 1ST ST, SUITE 703, HIGHLAND PARK, IL 60035-3200
(847) 433-1539
Mailing address
161 PROVIDENCE DR, MATTESON, IL 60443-1396

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
WY
367500000X
Certified Registered Nurse Anesthetist
Primary
209007843
IL

Other

Enumeration date
10/15/2009
Last updated
12/15/2017
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